Provider portal

ABSTRACT

Various systems and methods are provided that graphically allow health insurance company personnel to identify patient diagnoses that are not accounted for by the health insurance company. Furthermore, the various systems and methods graphically allow health insurance company personnel to identify patients that have not submitted claims for documented ailments or conditions. Thus, the health insurance company may be able to improve its chances of receiving transfer payments from other health insurance companies and/or receiving higher star ratings.

TECHNICAL FIELD

The present disclosure relates to systems and techniques for dataintegration, analysis, and visualization.

BACKGROUND

Prior to the passing of the Patient Protection and Affordable Care Act(PPACA), insurers were permitted to charge higher premiums forindividuals with preexisting conditions (e.g., cancer, heart disease,diabetes, etc.) because such individuals cost the insurer proportionallymore in comparison to healthier members. This caused insurance for thesickest and oldest of Americans to be all but unaffordable in manycases. To combat this, individual plans offered via state andfederally-administered exchanges are now limited in the scope ofconditions that can be used in the pricing of a policy. For example,premiums can be adjusted upwards for individuals who are smokers and/orbased on age. However, insurers cannot price the terminal cancer patientout of a policy. The most expensive premium for a given individual on aplan is also capped at three times the cheapest premium on the plan.

However, the fact remains that individuals with preexisting conditionsstill cost insurers more than healthy individuals. The government,worried that insurers may try to find ways to discriminate against thesickest individuals, implemented a program of risk adjustment. Thepremise is that insurers that can prove they are insuring a sickerpopulation in comparison to other insurers will be eligible for transferpayments. Thus, insurers with healthier individuals will send money tothose with sicker individuals.

In addition, every Medicare Advantage plan offered by insurers is givena rating according to a five-star quality rating system. Thewhole-number star rating is assigned by virtue of performance acrossover 50 individual metrics that come from the Healthcare EffectivenessData and Information Set (HEDIS), the Consumer Assessment of HealthcareProviders and Systems (CAHPS), the Centers for Medicare and MedicaidServices (CMS), the Health Outcomes Survey (HOS), and/or the IndependentReview Entity (IRE). The star rating may generally measure the qualityof a plan and customer satisfaction with a plan.

Before the PPACA was implemented, insurers received bonus payments basedupon the star ratings given to their plans. For example, insurersreceived a 5% bonus for 5 stars, a 4% bonus for 4 stars, and so forth.Under the PPACA, new performance payments have been added. For example,4 or 5-star plans will get an additional 1.5% on top of the initialdetermined amount. These bonus payments increase over time, reachingtowards 5% by 2014. Thus, the star rating system has gained moreimportance under the PPACA.

Over time, insurers can receive claims from healthcare providers. Theclaims can be used to determine transfer payments and star ratings.However, such a collection may include a large number of claims and/orrelated data that may be stored in an electronic data store or memory.For example, such a collection of claims may include hundreds ofthousands, millions, tens of millions, hundreds of millions, or evenbillions of claims and/or related data, and may consume significantstorage and/or memory. Determination, selection, and analysis ofrelevant claims and/or related data within such a collection may beextremely difficult for an insurer. Furthermore, processing of such alarge collection of claims and/or related data (e.g., as an employee ofan insurer uses a computer to sift and/or search through huge numbers ofclaims and/or related data) may be extremely inefficient and consumesignificant processing and/or memory resources.

SUMMARY

The systems, methods, and devices described herein each have severalaspects, no single one of which is solely responsible for its desirableattributes. Without limiting the scope of this disclosure, severalnon-limiting features will now be discussed briefly.

Embodiments of the present disclosure relate to the automatic selectionof a subset of the received claims and/or related data and to thegeneration of graphical user interfaces that display the subset. Thesubset of claims and/or related data may include far fewer claims and/orrelated data (e.g., several orders of magnitude smaller) than thecollection described above. In various embodiments, the graphical userinterfaces allow health insurance company personnel to identify patientdiagnoses that are not accounted for by the health insurance company.Furthermore, the graphical user interfaces allow health insurancecompany personnel to identify patients that have not submitted claimsfor documented ailments or conditions. Accordingly, in an embodiment,processing of the subset of claims and/or related data may be tooptimize computing resources as compared to the collection describedabove. Thus, the health insurance company may be able to improve itschances of receiving transfer payments from other health insurancecompanies and/or receiving higher star ratings.

One aspect of the disclosure provides a computing system configured toprocess a large amount of dynamically updating data. The computingsystem comprises a network interface coupled to a data network forreceiving and transmitting one or more packet flows. The computingsystem further comprises a computer processor. The computing systemfurther comprises a computer readable storage medium storing programinstructions configured for execution by the computer processor in orderto cause the computing system to access medical data associated with aplurality of patients, wherein the medical data comprises an ailmentidentified as affecting the respective patient. The computer readablestorage medium further stores program instructions configured forexecution by the computer processor in order to access a plurality ofmedical claims, wherein each medical claim corresponds to at least oneof the plurality of patients and is associated with one of a pluralityof healthcare providers. The computer readable storage medium furtherstores program instructions configured for execution by the computerprocessor in order to determine a first set of medical claims in theplurality of medical claims that comprise claims for reimbursement fortreatments of ailments not identified as affecting the respectivepatient. The computer readable storage medium further stores programinstructions configured for execution by the computer processor in orderto generate a user interface comprising a provider window depicting aselectable list of one or more of the plurality of healthcare providers,and a claim adjustment window. The user interface may be configured toreceive a selection of a first healthcare provider in the list ofhealthcare providers and, in response to selection of the firsthealthcare provider, display, in the claim adjustment window, one ormore medical claims in the first set of medical claims that are eachassociated with the first healthcare provider.

The computing system of the preceding paragraph can have anysub-combination of the following features: the user interface furthercomprises a gaps in care window; where the program instructions arefurther configured to cause the computing system to determine a firstset of patients in the plurality of patients that have not submitted,during a first period of time, a claim for reimbursement for a treatmentof an ailment identified as affecting the respective patient, where theuser interface is further configured to display, in the gaps in carewindow for each user in the first set of patients that is associatedwith the first healthcare provider, a notification to contact therespective patient; the user interface is further configured to display,in the provider window, a plurality of histograms, and where eachhistogram is associated with a healthcare provider in the plurality ofhealthcare providers; each histogram is configured to indicate a numberof medical claims in the first set of medical claims that are associatedwith the respective provider when the claim adjustment window isselected; each histogram is configured to indicate a number of patientsin the first set of patients that are associated with the respectiveprovider when the gaps in care window is selected; each histogramcomprises information displayed using a logarithmic scale; where theprogram instructions are further configured to cause the computingsystem to receive a selection of a first notification to contact a firstpatient in the first set of patients, where the user interface isconfigured to display, in the gaps in care window, a schedule windowthat overlaps at least a portion of the first notification, where theschedule window comprises an option to indicate that an appointment hasbeen scheduled with the first patient and an option to indicate that theappointment with the first patient has been completed; the gaps in carewindow comprises a new window and a scheduled appointment window, wherethe new window comprises the first notification, and where the userinterface is further configured to display, in the scheduled appointmentwindow and not the new window, the first notification in connection witha selection of the option to indicate that the appointment has beenscheduled with the first patient; the gaps in care window comprises afirst notification to contact a first patient in the first set ofpatients and a notification number associated with the firstnotification that indicates a number of reasons to contact the firstpatients; the user interface is further configured to display, in thegaps in care window, a second notification to contact the first patientand a third notification to contact the first patient in connection witha selection of the first notification; and the user interface comprisesa sort button, and where the sort button, when selected, causes theclaim adjustment window to display the one or more medical claims in thefirst set of medical claims in one of an alphabetical order, an orderbased on date, or an order based on importance of the respective medicalclaim.

Another aspect of the disclosure provides a computer-implemented methodof processing a large amount of dynamically updating data. Thecomputer-implemented method comprises, as implemented by one or morecomputer systems comprising computer hardware and memory, the one ormore computer systems configured with specific executable instructions,accessing medical data associated with a plurality of users, wherein themedical data comprises an ailment identified as affecting the respectiveuser. The computer-implemented method further comprises accessing aplurality of user claims, wherein each user claim corresponds to atleast one of the plurality of users and is associated with one of aplurality of healthcare providers. The computer-implemented methodfurther comprises determining, based on the accessed medical data, afirst set of users claims in the plurality of user claims that compriseclaims for reimbursement for treatments of ailments not identified asaffecting the respective user. The computer-implemented method furthercomprises generating a user interface comprising a provider windowdepicting a selectable list of one or more of the plurality ofhealthcare providers, and a claim adjustment window. Thecomputer-implemented method further comprises receiving a selection of afirst healthcare provider in the list of healthcare providers. Inresponse to selection of the first healthcare provider, thecomputer-implemented method further comprises updating the claimadjustment window of the user interface to include one or more userclaims in the first set of user claims that are each associated with thefirst healthcare provider.

The computer-implemented method of the preceding paragraph can have anysub-combination of the following features: the user interface furthercomprises a gaps in care window; where the computer-implemented methodfurther comprises determining a first set of users in the plurality ofusers that have not submitted, during a first period of time, a claimfor reimbursement for a treatment of an ailment identified as affectingthe respective user, and updating the gaps in care window, for each userin the first set of users that is associated with the first healthcareprovider, to include a notification to contact the respective user; andwhere the computer-implemented method further comprises updating theprovider window to include a plurality of histograms, wherein eachhistogram is associated with a healthcare provider in the plurality ofhealthcare providers.

Another aspect of the disclosure provides a non-transitorycomputer-readable medium comprising one or more program instructionsrecorded thereon, the instructions configured for execution by acomputing system comprising one or more processors in order to cause thecomputing system to access medical data associated with a plurality ofusers, wherein the medical data comprises an ailment identified asaffecting the respective user. The computer-readable medium furthercomprises one or more program instructions configured for execution inorder to cause the computing system to access a plurality of userclaims, wherein each user claim corresponds to at least one of theplurality of users and is associated with one of a plurality ofhealthcare providers. The computer-readable medium further comprises oneor more program instructions configured for execution in order to causethe computing system to determine a first set of users claims in theplurality of user claims that comprise claims for reimbursement fortreatments of ailments not identified as affecting the respective user.The computer-readable medium further comprises one or more programinstructions configured for execution in order to cause the computingsystem to generate a user interface comprising a selectable list of oneor more of the plurality of healthcare providers. The computer-readablemedium further comprises one or more program instructions configured forexecution in order to cause the computing system to receive a selectionof a first healthcare provider in the list of healthcare providers. Thecomputer-readable medium further comprises one or more programinstructions configured for execution in order to cause the computingsystem to, in response to selection of the first healthcare provider,update the user interface to include one or more user claims in thefirst set of user claims that are each associated with the firsthealthcare provider.

The non-transitory computer-readable medium of the preceding paragraphcan have any sub-combination of the following features: where theinstructions are further configured to cause the computing system todetermine a first set of users in the plurality of users that have notsubmitted, during a first period of time, a claim for reimbursement fora treatment of an ailment identified as affecting the respective user,and update the user interface, for each user in the first set of usersthat is associated with the first healthcare provider, to include anotification to contact the respective user; where the instructions arefurther configured to cause the computing system to update the userinterface to include a plurality of histograms, and where each histogramis associated with a healthcare provider in the plurality of healthcareproviders; and each histogram is configured to indicate a number of userclaims in the first set of user claims that are associated with therespective provider.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a block diagram of a system for collecting andanalyzing claims.

FIG. 2 illustrates a user interface displaying claims adjustments forreview.

FIGS. 3A-C illustrate user interfaces displaying the selection andarchiving of a pending claim adjustment.

FIG. 4 illustrates a user interface displaying gaps in care for review.

FIGS. 5A-5K illustrate user interfaces displaying the selection,scheduling, and completion of a gaps in care item.

FIGS. 6A-6B illustrate user interfaces displaying the expansion of gapsin care items that have been combined for a single patient.

FIGS. 7A-7B illustrate user interfaces displaying the expansion ofscheduled and unscheduled gaps in care items that have been combined fora single patient.

FIG. 8 is a flowchart depicting an illustrative operation of displayingclaims adjustments.

FIG. 9 illustrates a computer system with which certain methodsdiscussed herein may be implemented.

DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS Overview

As described above, the Patient Protection and Affordable Care Act(PPACA) allows for insurers that can prove they are insuring a sickerpopulation in comparison to other insurers to be eligible for transferpayments. Thus, insurers may have an incentive to ensure that their riskpool looks as unappealing as possible. In other words, insurers may havean incentive to make sure everyone with expensive chronic diseases orother ailments that are indicative of an unhealthy individual areproperly accounted for.

In addition, as described above, every Medicare Advantage plan offeredby insurers is given a rating according to a five-star quality ratingsystem that has gained more importance under the PPACA. Thus, insurersmay be looking to improve their plan ratings in order to receive theextra benefits provided by the PPACA.

Accordingly, disclosed herein are various systems and methods that allowinsurers to collect and analyze medical and/or pharmaceutical claimssuch that the ailments of insured individuals can be properly accountedfor and/or the star ratings for plans can be improved or at leastmaintained. For example, the various systems described herein maydetermine, based on received claims, patient diagnoses that are notaccounted for by a health insurance company and display such informationin a user interface. Thus, health insurance company personnel may beable to visually identify such discrepancies and update the healthinsurance company records accordingly. As another example, the varioussystems described herein may identify patients that have not submittedclaims for documented ailments or conditions. Such information may bedisplayed in a user interface as well. Thus, health insurance companypersonnel may be able to identify patients who may not be seekingtreatment (or may have failed to report that treatments were acquired)and contact such patients to schedule appointments, thereby working toimprove and/or maintain a plan's star rating.

Claim Collection and Analysis System Overview

FIG. 1 illustrates a block diagram of a system 100 for collecting andanalyzing claims. The system 100 comprises one or more providers 110, aninsurer device 130, a provider portal 135, a prescription and medicalclaims data sever 140, a patient 150, and a network 120.

In the embodiment illustrated in FIG. 1, the one or more providers 110(e.g., doctors, hospitals, pharmacies, etc.), which may be implementedby one or more first physical computing devices, are communicativelyconnected to the prescription and medical claims data server 140, whichmay be implemented by one or more second physical computing devices,over the network 120. Similarly, the insurer device 130 (e.g., operatedby an insurance company, such as Blue Cross, Health Net, or KaiserPermanente) may be implemented by one or more third physical computingdevices and may be communicatively connected to the prescription andmedical claims data server 140 over the network 120. The prescriptionand medical claims data server 140 can be operated by the insurancecompany or can be operated by a third party (e.g., a company thatcontracts with an insurance company, a healthcare provider, etc.). Thepatient 150, which may be implemented by one or more fourth physicalcomputing devices, may likewise be communicatively connected to theinsurer device 130 over the network 120. In some embodiments, each suchphysical computing device may be implemented as a computer systemincluding some or all of the components illustrated in the examplecomputing system 900 of FIG. 9. For example, the one or more providers110, the insurer device 130, the prescription and medical claims dataserver 140, and/or the patient 150 may be implemented in a computersystem as a set of program instructions recorded on a machine-readablestorage medium.

The one or more providers 110 represent devices operated by healthcareproviders (e.g., doctors, hospitals, pharmacies, etc.). Healthcarepersonnel (e.g., doctors, nurses, pharmacists, hospital or clinic staff,etc.) may submit medical and/or pharmaceutical claims to insurancecompanies (e.g., health insurance companies) on behalf of patients.Medical claims may include claims that are submitted to insurancecompanies to receive payment for medical services administered by thehealthcare provider. Likewise, pharmaceutical claims may include claimsthat are submitted to insurance companies to receive payment for drugsdistributed by the healthcare provider. These claims may be transmittedto the prescription and medical claims data server 140 for storageand/or for access by the insurer device 130. In some embodiments,information related to patient ailments entered into electronic medicalrecord (EMR) systems (e.g., referred to herein as “EMR data”) may alsobe transmitted to the prescription and medical claims data server 140for storage and used in a manner as described herein with the medicaland/or pharmaceutical claims. In some embodiments, lab claims and/or labresults may also be transmitted to the prescription and medical claimsdata server 140 for storage and used in a manner as described hereinwith the medical and/or pharmaceutical claims.

The insurer device 130 represents a device operated by a healthinsurance company that allows insurance company personnel to analyzepharmaceutical and/or medical claims received from the prescription andmedical claims data server 140 and identify expected pharmaceuticaland/or medical claims that were not received, for example. In anembodiment, the insurer device comprises a provider portal 135, whichallows insurance company personnel to analyze claims, manipulate claims,identify claims that were not received, and/or contact patients via agraphical user interface (GUI). For example, the provider portal 135 mayinclude GUI logic. The GUI logic may be a set of program instructionsconfigured for execution by one or more computer processors of theinsurer device 130, which are operable to receive user input and todisplay a graphical representation of claims using the approachesdescribed herein. The GUI logic may be operable to receive user inputfrom, and display a graphical representation of the claims, in a GUIthat is provided on a display (not shown) of the insurer device 130and/or another computing device that is in communication with theprovider portal 135.

The prescription and medical claims data server 140 may be implementedas a special-purpose computer system having logical elements. In anembodiment, the logical elements may comprise program instructionsrecorded on one or more machine-readable storage media. Alternatively,the logical elements may be implemented in hardware, firmware, or acombination thereof.

When executed by one or more processors of the computer system, logic inthe prescription and medical claims data server 140 is operable toreceive, store, analyze, and/or manipulate claims and/or identify claimsthat were not received according to the techniques described herein. Forexample, the prescription and medical claims data server 140 maycomprise the provider portal 135 (not shown), which can then be accessedby another device, such as the insurer device 130, via a networkinterface (e.g., a browser). In one embodiment, the provider portal 135and/or the prescription and medical claims data server 140 may beimplemented in a Java Virtual Machine (JVM) that is executing in adistributed or non-distributed computer system. In other embodiments,the provider portal 135 and/or the prescription and medical claims dataserver 140 may be implemented as a combination of programminginstructions written in any programming language (e.g. C++ or VisualBasic) and hardware components (e.g., memory, CPU time) that have beenallocated for executing the program instructions.

In an embodiment, the network 120 includes any communications network,such as the Internet. The network 120 may be a wired network, a wirelessnetwork, or a combination of the two. For example, network 120 may be alocal area network (LAN) and/or a wireless area network (WAN).

Claims Adjustments

FIG. 2 illustrates a user interface 200 displaying claims adjustmentsfor review. As illustrated in FIG. 2, the interface 200 includes a firstpane 210 and a second pane 212. The first pane 210 may include a list oftasks and a list of healthcare providers. For example, the tasks mayinclude an inbox 214 and an archived box 216. The list of healthcareproviders may include healthcare providers 218A-L. For illustrativepurposes, the inbox 214 and the healthcare provider 218A are selected inthe first pane 210. The second pane 212 may include a claims adjustmentstab 220 and a gaps in care tab 222. For illustrative purposes, theclaims adjustments tab 220 is selected. The user interface 200 may begenerated and/or displayed by the provider portal 135 as describedabove.

In an embodiment, the claim adjustments tab 220 includes a list ofclaims adjustments. As used herein, claims adjustments comprise claimsfor reimbursement submitted on behalf of individuals that relate totreatments for ailments or conditions not identified by an insurancecompany as affecting the respective individual. For example, theprescription and medical claims data server 140 may receive claims forreimbursements submitted on behalf of patients. The prescription andmedical claims data server 140 and/or a data store accessible by theinsurer device 130 (not shown) may store a record of the ailments orconditions a patient has been diagnosed with. Such record may bemaintained by the health insurance company. The prescription and medicalclaims data server 140 and/or the insurer device 130 may compare patientdiagnoses with claims submitted on behalf of the respective patients.Any claims that do not correspond with a patient diagnosis may beflagged and provided to the provider portal 135.

The claim adjustments tab 220 may include pending claims adjustments(e.g., claims adjustments for which corresponding patient records havenot yet been updated) when the inbox 214 is selected. The claimsadjustments tab 220 may include completed claims adjustments (e.g.,claims adjustments for which corresponding patient records have beenupdated) when the archived box 216 is selected. For example, the insurerdevice 130 can be used to update the record of the ailments orconditions a patient has been diagnosed with based on the claimsadjustments such that the records are kept accurate. Pending claimsadjustments may indicate that the record has not been updated andcompleted claims adjustments may indicate that the record has beenupdated. Thus, the claim adjustments tab 220 allows health insurancecompany personnel to view unreported diagnoses and update their recordsaccordingly to increase the possibility of receiving transfer paymentsfrom other health insurance companies and/or other third parties.

The claims adjustments that are displayed in the user interface 200 maybe organized by healthcare providers. For example, the claim adjustmentsdisplayed when the claims adjustments tab 220 is selected and when thehealthcare provider 218A is selected may be for individuals that arepatients of the healthcare provider 218A. The claim adjustments tab 220may indicate a number of claim adjustments that are associated with theselected healthcare provider 218A-L.

Each claim adjustment may include a patient identification and claiminformation. For example, claim adjustment 230 includes a patientidentification of “Patient #200016382” and claim information including aclaim number (e.g., Claim #155385), a date the claim was made (e.g.,Sep. 22, 2013), and claim notes (e.g., a diagnosis that is missing, thetype of prescriptions used by the individual, when the prescriptionswere used, etc.).

The inbox 214 may be associated with task number 215. The task number215 may represent a total number of pending claims adjustments and atotal number of pending gaps in care, which are described in greaterdetail below, for all individuals associated with the healthcareproviders 218A-L.

The first pane 210 may further include a sort button 217. When selected,a user may be able to sort healthcare providers 218A by name, bylocation, by type of practice, by number of claims adjustments, bynumber of gaps in care, by risk posed by the healthcare provider (e.g.,a larger number of claims adjustments and/or gaps in care may be riskierthan a smaller number of the same), and/or the like.

Likewise, the second pane 212 may include a sort button 227. Whenselected, a user may be able to sort the claim adjustments listed in theclaim adjustments tab 220 by patient name or number, by date, by type ofailment or condition, by importance, severity, or urgency (e.g., amissed diagnosis of cancer may be considered more important to recordthan a missed diagnosis of depression), and/or the like.

In an embodiment, the first pane 210 includes graphs, such as histogramsor stacked bar graphs, associated with each of the healthcare providers218A-L. For example, the healthcare provider 218L is associated with thegraph 244. Each graph includes a first box that represents a number ofpending claims adjustments and a second box that represents a number ofpending gaps in care. For example, the graph 244 includes first box 240and second box 242. The graphs may be based on a linear scale, alogarithmic scale, and/or the like. Each of the graphs may have the sameand/or a different scale. Thus, the width of the first box and/or thesecond box may represent an absolute number of claims adjustments orgaps in care when compared to the widths of other first boxes and secondboxes and/or may represent a relative number of claims adjustments togaps in care with respect to the particular healthcare provider.

FIGS. 3A-C illustrate user interfaces 300 displaying the selection andarchiving of a pending claim adjustment 332. As illustrated in FIG. 3A,a user on behalf of a health insurance company, using a cursor 350, mayselect the claim adjustment 332. For example, the user may select theclaim adjustment 332 by placing the cursor 350 over a portion of theclaim adjustment 332 (e.g., the box in the claim adjustment 332 next tothe patient identification) and performing a selection operation (e.g.,clicking a mouse button, tapping a touch interface, double-tapping atouch interface, etc.). The claim adjustment 332 may be selected by theuser if the user has cleared the claim (e.g., updated the insurancecompany records such that the diagnosed ailment or condition of thepatient is recorded accordingly). As illustrated in FIG. 3A, the cursor350 is a mouse pointer, but may be any other indicia in otherembodiments.

As illustrated in FIG. 3B, once the claim adjustment 332 is selected,the claim adjustment 332 disappears from the claim adjustments 220 tab.In addition, the task number 215 is reduced (e.g., from 1644 to 1643)and the number of claims adjustments listed in the claims adjustmentstab 220 is reduced. Furthermore, in a graph 344 associated with thehealthcare provider 218A, the width of a first box 340 may be reduced toreflect the reduced number of pending claims adjustments. The claimadjustment 332 is moved to the archived box, which is displayed when thearchived box 216 is selected, as illustrated in FIG. 3C.

FIG. 4 illustrates a user interface 400 displaying gaps in care forreview. As illustrated in FIG. 4, the gaps in care tab 222 is selected.As used herein, gaps in care are items that indicate a patient orhealthcare provider has not submitted a claim for reimbursement for atreatment of an ailment or condition identified as affecting the patientat some previous time. A gaps in care item may be generated if the claimhas not been submitted within a certain period of time (e.g., a calendaryear). For example, a patient may have been diagnosed with diabetes, yetthe patient may not have scheduled an appointment to treat the conditionduring the calendar year. Thus, a gaps in care item may be generated forthe patient. Generation of the gaps in care item may also depend on theeligibility of a patient (e.g., gender, age, etc.). As described above,the prescription and medical claims data server 140 and/or a data storeaccessible by the insurer device 130 (not shown) may store a record ofthe ailments or conditions a patient has been diagnosed with. Such datamay be received directly from the providers 110. Such data may also begenerated based on appointment information received and stored by theprescription and medical claims data server 140 and/or the data storeaccessible by the insurer device 130. The appointment information mayinclude information relating to the last appointments scheduled (andattended) by the patient for a particular ailment or condition. Theprescription and medical claims data server 140 and/or the insurerdevice 130 may compare patient diagnoses with claims submitted on behalfof the respective patients. If no claims correspond with a particularpatient diagnosis, the lack of a claim for that patient may be flaggedand provided to the provider portal 135.

In an embodiment, the gaps in care tab 222 includes a new items window460 and a scheduled appointments window 462. The new items window 460includes pending gaps in care items (e.g., gaps in care items for whichappointments with patients have not been scheduled) and the scheduledappointments window 462 includes scheduled gaps in care items (e.g.,gaps in care items for which appointments with patients have beenscheduled).

A gaps in care item may include a patient identification, notes, and/orcontact information for the patient. For example, the gaps in care item430 includes a patient identification (e.g., Patient #200010065), notes(e.g., make appointment for diabetes), and a phone number for thepatient. The contact information (e.g., the phone number) may beselected to connect the user with the patient, such as the patient 150as illustrated in FIG. 1.

In some embodiments, there are multiple gaps in care items associatedwith a single patient. In such circumstances, the gaps in care items maybe grouped together and such grouping may be indicated. For example, thegaps in care item 432 includes a box 433 with a number inside (e.g., 2).The number may represent a number of gaps in care items associated withthe patient.

The graphs in the first pane 210 may transition from one view when theclaims adjustments tab 220 is selected to a second view when the gaps incare tab 222 is selected. For example, the first box and the second boxmay switch places, visualized via a continuous animation. As illustratedin FIG. 4, the second box 242 and the first box 240 in the graph 244have switched places.

FIGS. 5A-5K illustrate user interfaces 500 displaying the selection,scheduling, and completion of a gaps in care item 534. As illustrated inFIG. 5A, a user on behalf of a health insurance company, using a cursor550, may select the gaps in care item 534. When the sort button 227 isselected, a user may be able to sort the gaps in care items listed inthe gaps in care tab 222 by patient name or number, by date, by type ofailment or condition, by importance, severity, or urgency (e.g., amissed appointment for cancer treatments may be considered moreimportant to identify than a missed appointment for treatments fordepression), and/or the like.

The gaps in care item 534 may be selected by the user if the user hascontacted the patient to schedule an appointment and/or if theappointment has occurred, for example. As illustrated in FIG. 5B, awindow 552 appears in the new items window 460 when a gaps in care item,such as the gaps in care item 534, is selected. The window 552 maycomprise a “mark as scheduled” selection and a “mark as complete”selection. As illustrated in FIG. 5C, the user using the cursor 550 mayselect either selection. If “mark as scheduled” is selected, the gaps incare item 534 is moved from the new items window 460 to the scheduledappointments window 462, as illustrated in FIG. 5D. Alternatively, if“mark as complete” is selected, the gaps in care item 534 is removedfrom the new items window 460 and is visible when the archived box 216is selected (e.g., which displays gaps in care items that arecompleted), as illustrated in FIG. 5I.

As illustrated in FIG. 5E, the user may select the gaps in care item 534when it appears in the scheduled appointments window 462 using thecursor 550. Upon selecting a gaps in care item in the scheduledappointments window 462, such as the gaps in care item 534, a window 554may appear in the scheduled appointments window 462, as illustrated inFIG. 5F. The window 554 may comprise a “mark as new” selection and a“mark as complete” selection. As illustrated in FIG. 5G, the user usingthe cursor 550 may select either selection. If “mark as new” isselected, the gaps in care item 534 is moved from the scheduledappointments window 462 to the new items window 460, as illustrated inFIG. 5A. Alternatively, if “mark as complete” is selected, the gaps incare item 534 is removed from the scheduled appointments window 462, asillustrated in FIG. 5H, and is visible when the archived box 216 isselected, as illustrated in FIG. 5I.

Furthermore, as illustrated in FIG. 5H, the task number 215 may decrease(e.g., from 1644 to 1643) once a gaps in care item, such as the gaps incare item 534, is marked as complete. In addition, the second box 342may be adjusted (e.g., the width of the second box 342 may be reduced)to reflect the completion of a gaps in care item.

As illustrated in FIG. 5I, the user may select the archived box 216 toview completed gaps in care items. The completed gaps in care items maybe displayed in an archived item window 560. As illustrated in FIG. 5J,the user may select the gaps in care item 534 using the cursor 550.

Upon selection of the gaps in care item 534, a window 556 may appear inthe archived item window 560, as illustrated in FIG. 5K. The window 556may comprise a “mark as new” selection and a “mark as scheduled”selection. If “mark as new” is selected, the gaps in care item 534 ismoved from the archived item window 560 to the new items window 460, asillustrated in FIG. 5A. Alternatively, if “mark as scheduled” isselected, the gaps in care item 534 is moved from the archived itemwindow 560 to the scheduled appointments window 462, as illustrated inFIG. 5D.

FIGS. 6A-6B illustrate user interfaces 600 displaying the expansion ofgaps in care items that have been combined for a single patient. Asillustrated in FIG. 6A, the user may select the gaps in care item 432,which is a gaps in care item that indicates multiple gaps in care itemsare associated with the patient, using a cursor 650. In an embodiment,upon selection of the gaps in care item 432, the gaps in care item 432expands to show gaps in care items 632A-B, which are both associatedwith the same patient, as illustrated in FIG. 6B.

FIGS. 7A-7B illustrate user interfaces 700 displaying the expansion ofscheduled and unscheduled gaps in care items that have been combined fora single patient. As illustrated in FIG. 7A, the user may select thegaps in care item 432 using a cursor 750. In an embodiment, uponselection of the gaps in care item 432, the gaps in care item 432expands to show gaps in care items 732A-B, which are both associatedwith the same patient, as illustrated in FIG. 7B.

FIG. 7B further illustrates that the gaps in care item 732B has alreadybeen scheduled. The gaps in care item 732B is displayed in both the newitems window 460 and the scheduled appointments window 462. For example,the gaps in care item 732B displayed in the new items window 460includes a link (e.g., with the wording “SCHEDULED”) to the same gaps incare item 732B displayed in the scheduled appointments window 462. Thelink, when selected, may provide information on a time and/or locationwhen the appointment for the gaps in care item 732B has been scheduled.Thus, the user may readily access such information so that anappointment for the gaps in care item 732A may be scheduled near or atthe same time and/or location as the appointment for the gaps in careitem 732B.

Example Process Flow

FIG. 8 is a flowchart 800 depicting an illustrative operation ofdisplaying claims adjustments. Depending on the embodiment, the methodof FIG. 8 may be performed by various computing devices, such as by theinsurer device 130 and/or the prescription and medical claims dataserver 140. For ease of discussion, the method is discussed herein withreference to insurer device 130 and the provider portal 135 of theinsurer device 130. Depending on the embodiment, the method of FIG. 8may include fewer and/or additional blocks and the blocks may beperformed in an order different than illustrated.

In block 802, medical data associated with a plurality of users isaccessed. For example, the medical data may include diagnosis data for aplurality of patients (e.g., ailments or conditions that a patient isdiagnosed with). The medical data may be accessed from the providers 110and/or the prescription and medical claims data server 140 and providedto the insurer device 130.

In block 804, a plurality of user claims are accessed. In an embodiment,the user claims are prescription claims and/or medical claims. In afurther embodiment, the plurality of user claims are each associatedwith a healthcare provider in a plurality of healthcare providers.

In block 806, a first set of user claims in the plurality of user claimsthat comprise claims for reimbursement for treatments of ailments notidentified as affecting the respective user is determined. In anembodiment, the determination is made based on comparing the receivedmedical data with claims received on behalf of each respective patient.

In block 808, a user interface is generated that comprises a providerwindow and a claim adjustment window. In an embodiment, the providerwindow comprises a selectable list of one or more of the plurality ofhealthcare providers.

In block 810, a selection of a first healthcare provider in the list ofthe one or more of the plurality of healthcare providers is received. Inblock 812, the claim adjustment window is updated to include one or moreuser claims in the first set of user claims that are associated with thefirst healthcare provider.

Implementation Mechanisms

According to one embodiment, the techniques described herein areimplemented by one or more special-purpose computing devices. Thespecial-purpose computing devices may be hard-wired to perform thetechniques, or may include digital electronic devices such as one ormore application-specific integrated circuits (ASICs) or fieldprogrammable gate arrays (FPGAs) that are persistently programmed toperform the techniques, or may include one or more general purposehardware processors programmed to perform the techniques pursuant toprogram instructions in firmware, memory, other storage, or acombination. Such special-purpose computing devices may also combinecustom hard-wired logic, ASICs, or FPGAs with custom programming toaccomplish the techniques. The special-purpose computing devices may bedesktop computer systems, server computer systems, portable computersystems, handheld devices, networking devices or any other device orcombination of devices that incorporate hard-wired and/or program logicto implement the techniques.

Computing device(s) are generally controlled and coordinated byoperating system software, such as iOS, Android, Chrome OS, Windows XP,Windows Vista, Windows 7, Windows 8, Windows Server, Windows CE, Unix,Linux, SunOS, Solaris, iOS, Blackberry OS, VxWorks, or other compatibleoperating systems. In other embodiments, the computing device may becontrolled by a proprietary operating system. Conventional operatingsystems control and schedule computer processes for execution, performmemory management, provide file system, networking, I/O services, andprovide a user interface functionality, such as a graphical userinterface (“GUI”), among other things.

For example, FIG. 9 is a block diagram that illustrates a computersystem 900 upon which an embodiment may be implemented. For example, anyof the computing devices discussed herein, such as the insurer device130, the prescription and medical claims data server 140, the providers110, and the patient 150 may include some or all of the componentsand/or functionality of the computer system 900.

Computer system 900 includes a bus 902 or other communication mechanismfor communicating information, and a hardware processor, or multipleprocessors, 904 coupled with bus 902 for processing information.Hardware processor(s) 904 may be, for example, one or more generalpurpose microprocessors.

Computer system 900 also includes a main memory 906, such as a randomaccess memory (RAM), cache and/or other dynamic storage devices, coupledto bus 902 for storing information and instructions to be executed byprocessor 904. Main memory 906 also may be used for storing temporaryvariables or other intermediate information during execution ofinstructions to be executed by processor 904. Such instructions, whenstored in storage media accessible to processor 904, render computersystem 900 into a special-purpose machine that is customized to performthe operations specified in the instructions.

Computer system 900 further includes a read only memory (ROM) 908 orother static storage device coupled to bus 902 for storing staticinformation and instructions for processor 904. A storage device 910,such as a magnetic disk, optical disk, or USB thumb drive (Flash drive),etc., is provided and coupled to bus 902 for storing information andinstructions.

Computer system 900 may be coupled via bus 902 to a display 912, such asa cathode ray tube (CRT) or LCD display (or touch screen), fordisplaying information to a computer user. An input device 914,including alphanumeric and other keys, is coupled to bus 902 forcommunicating information and command selections to processor 904.Another type of user input device is cursor control 916, such as amouse, a trackball, or cursor direction keys for communicating directioninformation and command selections to processor 804 and for controllingcursor movement on display 912. This input device typically has twodegrees of freedom in two axes, a first axis (e.g., x) and a second axis(e.g., y), that allows the device to specify positions in a plane. Insome embodiments, the same direction information and command selectionsas cursor control may be implemented via receiving touches on a touchscreen without a cursor.

Computing system 900 may include a user interface module to implement aGUI that may be stored in a mass storage device as executable softwarecodes that are executed by the computing device(s). This and othermodules may include, by way of example, components, such as softwarecomponents, object-oriented software components, class components andtask components, processes, functions, attributes, procedures,subroutines, segments of program code, drivers, firmware, microcode,circuitry, data, databases, data structures, tables, arrays, andvariables.

In general, the word “module,” as used herein, refers to logic embodiedin hardware or firmware, or to a collection of software instructions,possibly having entry and exit points, written in a programminglanguage, such as, for example, Java, Lua, C or C++. A software modulemay be compiled and linked into an executable program, installed in adynamic link library, or may be written in an interpreted programminglanguage such as, for example, BASIC, Perl, or Python. It will beappreciated that software modules may be callable from other modules orfrom themselves, and/or may be invoked in response to detected events orinterrupts. Software modules configured for execution on computingdevices may be provided on a computer readable medium, such as a compactdisc, digital video disc, flash drive, magnetic disc, or any othertangible medium, or as a digital download (and may be originally storedin a compressed or installable format that requires installation,decompression or decryption prior to execution). Such software code maybe stored, partially or fully, on a memory device of the executingcomputing device, for execution by the computing device. Softwareinstructions may be embedded in firmware, such as an EPROM. It will befurther appreciated that hardware modules may be comprised of connectedlogic units, such as gates and flip-flops, and/or may be comprised ofprogrammable units, such as programmable gate arrays or processors. Themodules or computing device functionality described herein arepreferably implemented as software modules, but may be represented inhardware or firmware. Generally, the modules described herein refer tological modules that may be combined with other modules or divided intosub-modules despite their physical organization or storage

Computer system 900 may implement the techniques described herein usingcustomized hard-wired logic, one or more ASICs or FPGAs, firmware and/orprogram logic which in combination with the computer system causes orprograms computer system 900 to be a special-purpose machine. Accordingto one embodiment, the techniques herein are performed by computersystem 900 in response to processor(s) 904 executing one or moresequences of one or more instructions contained in main memory 906. Suchinstructions may be read into main memory 906 from another storagemedium, such as storage device 910. Execution of the sequences ofinstructions contained in main memory 906 causes processor(s) 904 toperform the process steps described herein. In alternative embodiments,hard-wired circuitry may be used in place of or in combination withsoftware instructions.

The term “non-transitory media,” and similar terms, as used hereinrefers to any media that store data and/or instructions that cause amachine to operate in a specific fashion. Such non-transitory media maycomprise non-volatile media and/or volatile media. Non-volatile mediaincludes, for example, optical or magnetic disks, such as storage device910. Volatile media includes dynamic memory, such as main memory 906.Common forms of non-transitory media include, for example, a floppydisk, a flexible disk, hard disk, solid state drive, magnetic tape, orany other magnetic data storage medium, a CD-ROM, any other optical datastorage medium, any physical medium with patterns of holes, a RAM, aPROM, and EPROM, a FLASH-EPROM, NVRAM, any other memory chip orcartridge, and networked versions of the same.

Non-transitory media is distinct from but may be used in conjunctionwith transmission media. Transmission media participates in transferringinformation between nontransitory media. For example, transmission mediaincludes coaxial cables, copper wire and fiber optics, including thewires that comprise bus 802. Transmission media can also take the formof acoustic or light waves, such as those generated during radio-waveand infra-red data communications.

Various forms of media may be involved in carrying one or more sequencesof one or more instructions to processor 804 for execution. For example,the instructions may initially be carried on a magnetic disk or solidstate drive of a remote computer. The remote computer can load theinstructions into its dynamic memory and send the instructions over atelephone line using a modem. A modem local to computer system 900 canreceive the data on the telephone line and use an infra-red transmitterto convert the data to an infra-red signal. An infra-red detector canreceive the data carried in the infra-red signal and appropriatecircuitry can place the data on bus 902. Bus 902 carries the data tomain memory 906, from which processor 904 retrieves and executes theinstructions. The instructions received by main memory 906 may retrieveand execute the instructions. The instructions received by main memory906 may optionally be stored on storage device 910 either before orafter execution by processor 904.

Computer system 900 also includes a communication interface 918 coupledto bus 902. Communication interface 918 provides a two-way datacommunication coupling to a network link 920 that is connected to alocal network 922. For example, communication interface 918 may be anintegrated services digital network (ISDN) card, cable modem, satellitemodem, or a modem to provide a data communication connection to acorresponding type of telephone line. As another example, communicationinterface 918 may be a local area network (LAN) card to provide a datacommunication connection to a compatible LAN (or WAN component tocommunicated with a WAN). Wireless links may also be implemented. In anysuch implementation, communication interface 918 sends and receiveselectrical, electromagnetic or optical signals that carry digital datastreams representing various types of information.

Network link 920 typically provides data communication through one ormore networks to other data devices. For example, network link 920 mayprovide a connection through local network 922 to a host computer 924 orto data equipment operated by an Internet Service Provider (ISP) 926.ISP 926 in turn provides data communication services through the worldwide packet data communication network now commonly referred to as the“Internet” 928. Local network 922 and Internet 928 both use electrical,electromagnetic or optical signals that carry digital data streams. Thesignals through the various networks and the signals on network link 920and through communication interface 918, which carry the digital data toand from computer system 900, are example forms of transmission media.

Computer system 900 can send messages and receive data, includingprogram code, through the network(s), network link 920 and communicationinterface 918. In the Internet example, a server 930 might transmit arequested code for an application program through Internet 928, ISP 926,local network 922 and communication interface 918.

The received code may be executed by processor 904 as it is received,and/or stored in storage device 910, or other non-volatile storage forlater execution.

Terminology

Each of the processes, methods, and algorithms described in thepreceding sections may be embodied in, and fully or partially automatedby, code modules executed by one or more computer systems or computerprocessors comprising computer hardware. The processes and algorithmsmay be implemented partially or wholly in application-specificcircuitry.

The various features and processes described above may be usedindependently of one another, or may be combined in various ways. Allpossible combinations and subcombinations are intended to fall withinthe scope of this disclosure. In addition, certain method or processblocks may be omitted in some implementations. The methods and processesdescribed herein are also not limited to any particular sequence, andthe blocks or states relating thereto can be performed in othersequences that are appropriate. For example, described blocks or statesmay be performed in an order other than that specifically disclosed, ormultiple blocks or states may be combined in a single block or state.The example blocks or states may be performed in serial, in parallel, orin some other manner. Blocks or states may be added to or removed fromthe disclosed example embodiments. The example systems and componentsdescribed herein may be configured differently than described. Forexample, elements may be added to, removed from, or rearranged comparedto the disclosed example embodiments.

Conditional language, such as, among others, “can,” “could,” “might,” or“may,” unless specifically stated otherwise, or otherwise understoodwithin the context as used, is generally intended to convey that certainembodiments include, while other embodiments do not include, certainfeatures, elements and/or steps. Thus, such conditional language is notgenerally intended to imply that features, elements and/or steps are inany way required for one or more embodiments or that one or moreembodiments necessarily include logic for deciding, with or without userinput or prompting, whether these features, elements and/or steps areincluded or are to be performed in any particular embodiment.

Any process descriptions, elements, or blocks in the flow diagramsdescribed herein and/or depicted in the attached figures should beunderstood as potentially representing modules, segments, or portions ofcode which include one or more executable instructions for implementingspecific logical functions or steps in the process. Alternateimplementations are included within the scope of the embodimentsdescribed herein in which elements or functions may be deleted, executedout of order from that shown or discussed, including substantiallyconcurrently or in reverse order, depending on the functionalityinvolved, as would be understood by those skilled in the art.

It should be emphasized that many variations and modifications may bemade to the above-described embodiments, the elements of which are to beunderstood as being among other acceptable examples. All suchmodifications and variations are intended to be included herein withinthe scope of this disclosure. The foregoing description details certainembodiments of the invention. It will be appreciated, however, that nomatter how detailed the foregoing appears in text, the invention can bepracticed in many ways. As is also stated above, it should be noted thatthe use of particular terminology when describing certain features oraspects of the invention should not be taken to imply that theterminology is being re-defined herein to be restricted to including anyspecific characteristics of the features or aspects of the inventionwith which that terminology is associated. The scope of the inventionshould therefore be construed in accordance with the appended claims andany equivalents thereof.

What is claimed is:
 1. A computing system configured to process a largeamount of dynamically updating data, the computing system comprising: anetwork interface coupled to a data network for receiving andtransmitting one or more packet flows; a display device; a computerprocessor; main memory; and a computer readable storage medium storing aplurality of program instructions configured for execution by thecomputer processor, wherein the plurality of program instructions areread into the main memory and accessed by the computer processor forexecution in order to cause the computing system to: access medical dataassociated with a plurality of patients from a physical computing deviceassociated with a medical facility over the data network; access aplurality of medical claims, wherein each medical claim corresponds toat least one of the plurality of patients and is associated with one ofa plurality of healthcare providers; determine a first set of medicalclaims in the plurality of medical claims and a second set of medicalclaims in the plurality of medical claims; generate and display, on thedisplay device, a user interface comprising a provider window and aclaim adjustment window, wherein the provider window depicts aselectable list of one or more of the plurality of healthcare providers;receive a selection of a first healthcare provider in the list ofhealthcare providers; and in response to the selection of the firsthealthcare provider, read a first program instruction in the pluralityof program instructions into the main memory for access by the computerprocessor, wherein execution of the first program instruction by thecomputer processor causes the display device to: display, in the claimadjustment window, one or more medical claims in the first set ofmedical claims that are each associated with the first healthcareprovider, display, in the provider window, a plurality of stacked bargraphs associated with a corresponding plurality of healthcareproviders, wherein a first stacked bar graph in the plurality of stackedbar graphs is associated with the first healthcare provider, whereineach stacked bar graph in the plurality of stacked bar graphs comprisesa first box and a second box, wherein a width of the first box is basedon a number of medical claims in the first set of medical claimsassociated with the respective healthcare provider, and wherein a widthof the second box is based on a number of the medical claims in thesecond set of medical claims associated with the respective healthcareprovider, receive an indication of a selection of a first medical claimin the one or more medical claims, in response to reception of theindication of the selection of the first medical claim, no longerdisplay, in the claim adjustment window, the first medical claim, andcause the width of the first box of the first stacked bar graph todecrease from a first width to a second width less than the first widthto reflect a reduced number of medical claims in the first set ofmedical claims that are associated with the first healthcare provider,and display an interactive element associated with a first patient inthe plurality of patients, wherein the interactive element is configuredto automatically initiate a communication between the computing systemand a physical computing device associated with the first patient whenselected.
 2. The computing system of claim 1, wherein the programinstructions are further configured to cause the computing system todetermine a first set of patients in the plurality of patients that havenot submitted, during a first period of time, a claim for reimbursementfor a treatment of an ailment identified as affecting the respectivepatient, wherein the user interface is further configured to display, ina gaps in care window in the user interface for each user in the firstset of patients that is associated with the first healthcare provider, anotification to contact the respective patient.
 3. The computing systemof claim 2, wherein the program instructions are further configured tocause the computing system to receive a selection of a firstnotification to contact the first patient in the first set of patients,wherein the user interface is further configured to display, in the gapsin care window, a schedule window that overlaps at least a portion ofthe first notification, wherein the schedule window comprises an optionto indicate that an appointment has been scheduled with the firstpatient and an option to indicate that the appointment with the firstpatient has been completed.
 4. The computing system of claim 3, whereinthe gaps in care window comprises a new window and a scheduledappointment window, wherein the new window comprises the firstnotification, and wherein the user interface is further configured todisplay, in the scheduled appointment window and not the new window, thefirst notification in connection with a selection of the option toindicate that the appointment has been scheduled with the first patient.5. The computing system of claim 2, wherein the gaps in care windowcomprises a first notification to contact the first patient in the firstset of patients and a notification number associated with the firstnotification that indicates a number of reasons to contact the firstpatients.
 6. The computing system of claim 5, wherein the user interfaceis further configured to display, in the gaps in care window, a secondnotification to contact the first patient and a third notification tocontact the first patient in connection with a selection of the firstnotification.
 7. The computing system of claim 1, wherein each stackedbar graph comprises information displayed using a logarithmic scale. 8.The computing system of claim 1, wherein the user interface comprises asort button, and wherein the sort button, when selected, causes theclaim adjustment window to display the one or more medical claims in thefirst set of medical claims in one of an alphabetical order, an orderbased on date, or an order based on importance of the respective medicalclaim.
 9. The computing system of claim 1, wherein the plurality ofprogram instructions are read into the main memory and accessed by thecomputer processor for execution in order to cause the computing systemto, in response to a selection of the interactive element, read a secondprogram instruction in the plurality of program instructions into themain memory for access by the computer processor, wherein execution ofthe second program instruction by the computer processor causes thenetwork interface to initiate the communication between the computingsystem and the physical computing device associated with the firstpatient.
 10. The computing system of claim 1, wherein medical claims inthe first set of medical claims that are associated with a secondpatient comprise claims for reimbursement for treatment of a firstailment, and wherein the first ailment is not identified by an entity asaffecting the second patient.
 11. A computer-implemented method ofprocessing a large amount of dynamically updating data, thecomputer-implemented method comprising: as implemented by one or morecomputer systems comprising a computer processor, a display device, andmain memory, the one or more computer systems configured with specificexecutable instructions, accessing medical data associated with aplurality of users; accessing a plurality of user claims, wherein eachuser claim corresponds to at least one of the plurality of users and isassociated with one of a plurality of healthcare providers; determining,based on the accessed medical data, a first set of user claims in theplurality of user claims and a second set of user claims in theplurality of user claims; generating and displaying, on the displaydevice, a user interface comprising a provider window and a claimadjustment window, wherein the provider window depicts a selectable listof one or more of the plurality of healthcare providers; receiving aselection of a first healthcare provider in the list of healthcareproviders; and in response to the selection of the first healthcareprovider, reading a first program instruction in the plurality ofprogram instructions into the main memory for access by the computerprocessor, wherein execution of the first program instruction by thecomputer processor causes the display device to: display, in the claimadjustment window of the user interface, one or more user claims in thefirst set of user claims that are each associated with the firsthealthcare provider, display, in the provider window, a plurality ofstacked bar graphs associated with a corresponding plurality ofhealthcare providers, wherein a first stacked bar graph in the pluralityof stacked bar graphs is associated with the first healthcare provider,wherein each stacked bar graph in the plurality of stacked bar graphscomprises a first box and a second box, wherein a width of the first boxis based on a number of user claims in the first set of user claimsassociated with the respective healthcare provider, and wherein a widthof the second box is based on a number of the user claims in the secondset of user claims associated with the respective healthcare provider,receive an indication of a selection of a first medical claim in the oneor more medical claims, in response to reception of the indication ofthe selection of the first medical claim, no longer display, in theclaim adjustment window, the first medical claim, and cause the width ofthe first box of the first stacked bar graph to decrease from a firstwidth to a second width less than the first width to reflect a reducednumber of medical claims in the first set of medical claims that areassociated with the first healthcare provider, and display aninteractive element associated with a first patient in the plurality ofpatients, wherein the interactive element is configured to automaticallyinitiate a communication between the computing system and a physicalcomputing device associated with the first patient when selected. 12.The method of claim 11, further comprising: determining a first set ofusers in the plurality of users that have not submitted, during a firstperiod of time, a claim for reimbursement for a treatment of an ailmentidentified as affecting the respective user; and updating a gaps in carewindow in the user interface, for each user in the first set of usersthat is associated with the first healthcare provider, to include anotification to contact the respective user.
 13. The method of claim 11,wherein user claims in the first set of user claims that are associatedwith a second user comprise claims for reimbursement for treatment of afirst ailment, and wherein the first ailment is not identified by anentity as affecting the second patient.
 14. The method of claim 11,wherein each stacked bar graph comprises information displayed using alogarithmic scale.
 15. The method of claim 11, further comprisingreceiving a selection of a first notification to contact the first userin the first set of patients, wherein the user interface is furtherconfigured to display a schedule window that overlaps at least a portionof the first notification, and wherein the user interface comprises anoption to indicate that an appointment has been scheduled with the firstuser and an option to indicate that the appointment with the first userhas been completed.
 16. A non-transitory computer-readable mediumcomprising one or more program instructions recorded thereon, theinstructions configured for execution by a computing system comprisingone or more processors in order to cause the computing system to: accessmedical data associated with a plurality of users; access a plurality ofuser claims, wherein each user claim corresponds to at least one of theplurality of users and is associated with one of a plurality ofhealthcare providers; determine a first set of users claims in theplurality of user claims and a second set of user claims in theplurality of user claims; generate and display, on a display device, auser interface comprising a selectable list of one or more of theplurality of healthcare providers; receive a selection of a firsthealthcare provider in the list of healthcare providers; and in responseto the selection of the first healthcare provider, read a first programinstruction in the plurality of program instructions into main memoryfor access by the one or more processors, wherein execution of the firstprogram instruction by the one or more processors causes the displaydevice to: display, in the user interface, one or more user claims inthe first set of user claims that are each associated with the firsthealthcare provider, display, in the user interface, a plurality ofstacked bar graphs associated with a corresponding plurality ofhealthcare providers, wherein a first stacked bar graph in the pluralityof stacked bar graphs is associated with the first healthcare provider,wherein each stacked bar graph in the plurality of stacked bar graphscomprises a first box and a second box, wherein a width of the first boxis based on a number of user claims in the first set of user claimsassociated with the respective healthcare provider, and wherein a widthof the second box is based on a number of the user claims in the secondset of user claims associated with the respective healthcare provider,receive an indication of a selection of a first medical claim in the oneor more medical claims, in response to reception of the indication ofthe selection of the first medical claim, no longer display, in theclaim adjustment window, the first medical claim, and cause the width ofthe first box of the first stacked bar graph to decrease from a firstwidth to a second width less than the first width to reflect a reducednumber of medical claims in the first set of medical claims that areassociated with the first healthcare provider, and display aninteractive element associated with a first patient in the plurality ofpatients, wherein the interactive element is configured to automaticallyinitiate a communication between the computing system and a physicalcomputing device associated with the first patient when selected. 17.The medium of claim 16, wherein the instructions are further configuredto cause the computing system to: determine a first set of users in theplurality of users that have not submitted, during a first period oftime, a claim for reimbursement for a treatment of an ailment identifiedas affecting the respective user; and update the user interface, foreach user in the first set of users that is associated with the firsthealthcare provider, to include a notification to contact the respectiveuser.
 18. The medium of claim 16, wherein user claims in the first setof user claims that are associated with a second user comprise claimsfor reimbursement for treatment of a first ailment, and wherein thefirst ailment is not identified by an entity as affecting the secondpatient.
 19. The medium of claim 16, wherein each stacked bar graphcomprises information displayed using a logarithmic scale.